The Journal of Thoracic and Cardiovascular Surgery, Vol 89, 115-120, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Management of postcardiotomy hypertension by microcomputer-controlled administration of sodium nitroprusside
RA de Asla, AM Benis, RA Jurado and RS Litwak
Manual administration of sodium nitroprusside in patients who have
undergone cardiac operations can be associated with wide swings in mean
systemic arterial pressure. Moreover, it is necessary for constant
attention to be paid in order to minimize these potentially catastrophic
arterial pressure changes. A microcomputer-based controller was constructed
in the belief that it might improve the accuracy of systemic arterial
pressure control as well as relieve the clinical staff of a time-consuming
task. Comparison was made of the effectiveness of manual control versus
computer control of sodium nitroprusside infusion in two groups of patients
with similar clinical characteristics. In the manual control group the mean
systemic arterial pressure could be maintained within 5 mm Hg of the target
pressure only half (52%) of the time. In the computer-controlled group the
mean systemic arterial pressure was maintained within 5 mm Hg of the target
pressure 94% of the time (p less than 0.005). Thus, computerized control of
sodium nitroprusside infusion eliminated the need for an intensive care
unit nurse to be "locked into" the task of making frequent adjustments of
infusion rate. Of even greater importance, control of mean systemic
arterial pressure was more precise.
